山东大学耳鼻喉眼学报 ›› 2026, Vol. 40 ›› Issue (6): 22-29.

• 气道变态反应性疾病：从机制到实践 • 上一篇    

黄花蒿花粉变应原舌下滴剂治疗单一致敏与多重致敏变应性鼻炎患者的疗效及依从性研究

胡慧璇1,潘莉1,廖闻曦1,冯彦2   

  1. 1.山西医科大学 护理学院, 山西 太原 030001;
    2.山西医科大学第一医院 耳鼻咽喉头颈外科, 山西 太原 030001
  • 发布日期:2026-11-03
  • 通讯作者: 冯彦. E-mail:fengyan2006nian@163.com
  • 基金资助:
    山西省基础研究计划资助项目(202303021221218);山西省回国留学科研资助项目(2022-194)

Efficacy and compliance of Artemisia annua pollen allergen sublingual drops in the treatment of monosensitized and polysensitized allergic rhinitis patients

HU Huixuan1, PAN Li1, LIAO Wenxi1, FENG Yan2   

  1. 1. Nursing College of Shanxi Medical University, Taiyuan 030001, Shanxi, China2. Department of Otorhinolaryngology & Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
  • Published:2026-11-03

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摘要： 目的 评估黄花蒿花粉变应原舌下滴剂治疗蒿属花粉变应性鼻炎患者(sublingual immunotherapy, SLIT)的疗效和依从性,并分析其在单一致敏和多重致敏患者中的效果。 方法 采用单中心对照研究,纳入92例蒿属花粉变应性鼻炎患者,其中接受SLIT治疗的46例患者作为SLIT组,46例仅接受对症药物治疗的患者作为对照组。比较两组患者在治疗开始前花粉高峰期、治疗后1年、2年花粉高峰期的鼻部症状评分(total nasal symptom score, TNSS)、总用药评分(total medication score, TMS)、症状-药物联合评分(combined symptom and medication score, CSMS)、视觉模拟量表评分(the visual analogue scale, VAS),并记录脱落率。进一步将SLIT组患者分为单一致敏组和多重致敏组,以评估两组疗效差异。 结果 两组在基线时的年龄、性别、致敏状态、TNSS、TMS、CSMS、VAS差异无统计学意义(P=0.385,P=0.569,P=0.227,P=0.138,P=0.524,P=0.133,P=0.255),具有可比性;SLIT组中,蒿sIgE水平主要集中于3、4、5、6级,占蒿致敏人数的85.2%。对照组中,25人为多重致敏,最主要的过敏原为蒿和豚草。蒿sIgE水平主要集中于4、5级,占蒿致敏人数的61.54%;SLIT组治疗后第1年、第2年花粉高峰期TNSS、CSMS、VAS各项评分较基线均降低,组内比较差异均有统计学意义(P<0.001)。除TMS评分外,组间各评分在治疗1年后、2年后花粉高峰期比较差异均有统计学意义(P<0.01)。广义估计方程分析结果显示:TNSS、CSMS、VAS 评分的组间效应、时间效应、交互效应差异均有统计学意义(P<0.001),而TMS评分仅时间效应不显著(P>0.05)。鼻部症状中,打喷嚏和流鼻涕的组间差异无统计学意义(P>0.05),但鼻痒、鼻塞评分组间差异显著(P<0.001);所有症状的时间效应及交互效应均显著(P<0.001),提示两组患者症状评分随着时间的变化差异存在统计学意义;SLIT组单一致敏和多重致敏患者治疗前组间症状差异无统计学意义(P=0.940,P=0.667,P=0.188,P=0.806),治疗后一年、两年两组间疗效差值无统计学意义(P=0.737,P=0.9,P=0.384,P=0.607,P=0.476,P=0.498,P=0.876,P=0.696);最终脱落19例,其中5例(26.32%)无法坚持;4例(21.05%)无效;3例(15.79%)生活工作因素;3例(15.79%)疫情原因;2例(10.53%)费用大;1例(5.26%)有效;1例(5.26%)自觉加重。 结论 本研究表明,黄花蒿花粉变应原舌下滴剂对蒿属花粉变应性鼻炎具有长期疗效,但在单一致敏和多重致敏患者中疗效相当。这一发现为临床治疗提供了重要参考。未来研究应聚焦于多中心、大样本、长随访的设计,并借助大数据与机器学习技术开发疗效预测工具,以进一步优化治疗方案。

关键词: 变应性鼻炎, 舌下免疫治疗, 疗效, 单一致敏, 多重致敏

Abstract: Objective To evaluate the efficacy and compliance of Artemisia annua pollen allergen sublingual immunotherapy(SLIT)in patients with Artemisia pollen-induced allergic rhinitis, and to analyze its effectiveness in monosensitized and multisensitized patients. Methods A single-center controlled study was conducted, enrolling 92 patients with Artemisia pollen-induced allergic rhinitis. Among them, 46 patients receiving sublingual immunotherapy(SLIT)formed the SLIT group, while 46 patients receiving only symptomatic medication served as the control group. Compare the total nasal symptom score(TNSS), total medication score(TMS), combined symptom and medication score(CSMS), and visual analogue scale(VAS)scores between the two patient groups during the pollen peak season before treatment initiation, and at 1 and 2 years post-treatment. Additionally, record the dropout rate. Patients in the SLIT group were further divided into monosensitized and multisensitized subgroups to evaluate differences in treatment efficacy between the two groups. Results At baseline, there were no statistically significant differences between the two groups in age, gender, sensitization status, TNSS, TMS, CSMS, or VAS(P=0.385, P=0.569, P=0.227, P=0.138, P=0.524, P=0.133, P=0.255), indicating comparability. In the SLIT group, Artemisia slgE levels predominantly fell within grades 3, 4, 5, and 6, accounting for 85.2%of Artemisia-sensitized individuals. In the control group, 25 subjects exhibited multiple sensitivities, with Artemisia and ragweed as the primary allergens. Artemisia slgE levels primarily clustered at grades 4 and 5, representing 61.54% of Artemisia-sensitized individuals. In the SLIT group, TNSS, CSMS, and VAS scores during pollen peak seasons in the first and second years post-treatment were significantly lower than baseline values, with statistically significant differences observed within the group(P<0.001). Except for TMS scores, statistically significant differences were found between groups for all scores during pollen peak seasons at 1 and 2 years post-treatment(P<0.01). Results from generalized estimating equations analysis showed statistically significant differences in between-group effects, time effects, and interaction effects for TNSS, CSMS, and VAS scores(P<0.001). Only the time effect for TMS scores was not significant(P>0.05). Among nasal symptoms, intergroup differences in sneezing and rhinorrhea were not statistically significant(P>0.05), but differences in nasal itching and nasal congestion scores were significant(P<0.001). Time effects and interaction effects for all symptoms were significant(P<0.001), indicating statistically significant differences in symptom score changes over time between the two groups. There were no statistically significant differences in pre- treatment symptoms between monosensitized and multisensitized patients in the SLIT group(P=0.940, P=0.667, P=0.188, P=0.806), and no statistically significant differences in treatment efficacy were observed between the two groups at one and two years post-treatment(P=0.737, P=0.9, P=0.384, P=0.607, P=0.476, P=0.498, P=0.876, P=0.696). A total of 19 participants ultimately dropped out: 5 cases(26.32%)were unable to persist; 4cases(21.05%)showed no improvement; 3 cases(15.79%)cited personal or work-related factors; 3 cases(15.79%)attributed to pandemic-related reasons; 2 cases(10.53%)cited high costs; 1 case(5.26%)reported improvement;1 case(5.26%)perceived worsening symptoms. Conclusion This study demonstrates that Artemisia annua pollen allergen sublingual drops exhibit long-term efficacy for allergic rhinitis caused by Artemisia pollen, with comparable therapeutic effects observed in both monosensitized and multisensitized patients. This finding provides important reference for clinical treatment. Future research should focus on multicenter, large- sample, long-follow-up designs, and leverage big data and machine learning technologies to develop efficacy prediction tools, thereby further optimizing treatment regimens.

Key words: Allergic rhinitis, Sublingual immunotherapy, Efficacy, Single sensitization, Multiple sensitization

中图分类号: 

  • R765.21
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